SEC Form 4 · accession 0001019687-16-007307
Rennova Health, Inc. · RNVA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael Louis Goldberg
Director
Period of report
Jul 17, 2016
Accepted (ET)
Aug 18, 2016 · 5:27 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000931059
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Aug 5, 2016 | J | 26,667 | $0.30 | A | 26,667 | I | By: Monarch Capital LLC |
| Common Stock | holding | — | — | — | 7,110 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options to Purchase Common StockF2 | $0.30 | Jul 17, 2016 | A | 300,000 | A | — | Jul 17, 2026 | Common Stock | 300,000 | 300,000 | D |
Explanation of responses
- F1The Reporting Person received the shares in exchange for the cancellation of outstanding consulting fees.
- F2The options vest as follows: 100,000 on July 17, 2016; and 200,000 on December 31, 2016.